Average — CMS composite of the measures below.
A standard survey is most likely before around October 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Parma Care Center during CMS and state inspections, most recent first.
A resident with multiple comorbidities and known constipation had physician orders for routine stool softeners and laxatives, along with PRN Bisacodyl suppositories and Milk of Magnesia, and a care plan requiring bowel movement tracking and medication administration. Over several separate multi-day periods, no bowel movements were documented and no PRN bowel medications were recorded on the MAR, despite a facility policy requiring initiation of a bowel protocol after three days without a BM. The DON confirmed the bowel protocol was not started during these episodes, and the resident subsequently experienced abdominal pain and significant constipation requiring multiple ER evaluations and interventions, including imaging, suppositories, oral laxatives, and an enema.
A resident with hemiplegia, multiple psychiatric diagnoses, total dependence for ADLs, and consistently assessed as high fall risk required a mechanical (Hoyer) lift for all transfers. During a transfer from bed to wheelchair performed by two CNAs, one of the lift pad straps was not properly secured to the spreader bar, causing the resident to slip from the sling and fall to the floor. The resident reported pain to the head, elbow, and hip, and hospital imaging confirmed acute fractures of the left superior and inferior pubic rami. The facility’s investigation, supported by CNA statements and DON confirmation, identified the unsecured Hoyer strap as the direct cause of the fall and injury, and the resident subsequently expressed fear of further Hoyer lift transfers.
Food Served at Unappetizing Temperature: Meal service observations showed hot items were not maintained at an appetizing temperature during tray line service. A test tray with a breaded chicken patty on a bun and rice was measured as lukewarm, and the DM confirmed the food was not palatable. Facility policy required hot foods to be held at 135 degrees Fahrenheit or greater throughout service.
Kitchen Sanitation and Dish Machine Deficiencies: The facility failed to maintain a clean and sanitary kitchen area, with sticky floors, food debris, dried splatter on equipment and carts, dead bugs in light fixtures, a leaking sink line, and food stored near chemicals. The dish machine also failed to reach required sanitation temperatures, and the DM confirmed there were no written cleaning schedules in place.
Pest control was not effectively managed in the kitchen area. Multiple flies were observed throughout the kitchen and dish machine areas, and the DM confirmed their presence. The pest control invoice showed a general treatment for the kitchen, dishwashing area, and dry goods storage area, but it did not include house flies or fruit flies. Facility policy identified flies as common pests and required pest control in and around all buildings.
Call Light Not Within Reach for a Resident: A resident with DM2, dementia, anxiety, MDD, cirrhosis, chronic hepatitis C, C. diff, and COPD was observed lying in bed with the call light on the floor on two separate occasions. The resident’s MDS showed a BIMS of 13 and need for substantial to maximum assist with toileting and showers, with occasional bowel and bladder incontinence. Staff verified the call light was on the floor, despite the care plan and facility policy stating it should be kept within the resident’s reach.
Failure to provide oral care and shaving per preference. A resident with Huntington's disease, memory impairment, and total ADL dependence was observed with a thick film on his teeth, dry crust on his lips, and a full beard and moustache despite a documented preference to be clean shaven. A family member reported the resident was often unshaven and his teeth were not brushed, while an LPN confirmed oral care was expected every shift. A CNA said nursing did not shave him, and the beautician stated she only trimmed his beard and that nursing was to shave him afterward.
A resident with intact cognition, wheelchair use, and assistance needs for ADLs was found smoking outside near the entrance despite the facility being non-smoking. The record showed no smoking assessment or smoking care plan, even after staff educated the resident about the smoking policy and noted he had been caught smoking on the grounds. The DON and Administrator confirmed the assessment was not completed.
Infection control guidelines were not followed during incontinence care for a resident who was dependent on staff for all ADLs and always incontinent of bowel and bladder. A CNA cleansed the resident with gloves on, then touched clean linens, the privacy curtain, and the overbed table without removing the contaminated gloves, while another CNA placed soiled linens and an adult brief on the floor. The resident had diagnoses including Huntington's disease and had enhanced barrier precautions ordered and included in the care plan.
The facility failed to ensure accurate documentation and proper administration of controlled substances, including errors in medication records, removal of as-needed medications before they were needed, administration of medications without physician orders, and inaccurate documentation of medication administration. These deficiencies involved several residents with complex medical histories and resulted from staff not following established medication administration protocols.
Staff failed to perform hand hygiene during medication administration for two residents, including handling medications with bare hands and not sanitizing between residents. Additionally, isolation precautions were not implemented for a resident with confirmed influenza A, despite symptoms and a diagnosis, as required by facility policy. These deficiencies were confirmed through observation, record review, and staff interviews.
Failure to Implement Bowel Protocol and PRN Laxatives for Constipated Resident
Penalty
Summary
The deficiency involves the facility’s failure to timely implement and follow a bowel management protocol for a resident with multiple complex medical conditions and known constipation. The resident, admitted with diagnoses including cerebral infarction, stroke, malnutrition, hemiparesis, epilepsy, type II diabetes, schizoaffective disorder, bipolar disorder, and PTSD, was dependent on staff for toileting and was incontinent of bowel and bladder. The care plan identified constipation with interventions to record bowel movement patterns and administer medications as ordered. Physician orders included routine Docusate Sodium and Polyethylene Glycol for bowel management, as well as PRN Bisacodyl suppositories and Milk of Magnesia for constipation. Record review showed multiple periods where the resident had no documented bowel movements for several consecutive days, yet there was no documentation that PRN bowel medications were administered. Specifically, there were no documented bowel movements on several dates in December and January, and the MAR showed no administration of PRN Bisacodyl suppositories or Milk of Magnesia during those periods. Despite the facility’s bowel management policy stating that residents without a bowel movement for three consecutive days should have a specified bowel protocol initiated, the DON confirmed that the bowel protocol was not initiated on the dates when it should have been, based on the absence of bowel movements. During these episodes of unaddressed constipation, the resident experienced abdominal symptoms that led to multiple ER visits. An abdominal x-ray on one occasion showed a large, dilated bowel loop with a recommendation for a CT scan to rule out obstruction, and an ER summary documented significant constipation and stool burden treated with a suppository and oral laxatives. On another occasion, progress notes described the resident as inconsolable with abdominal pain, absent bowel sounds in lower abdominal quadrants, and pain on palpation, prompting transfer to the ER where the resident had a bowel movement. A later ER visit for possible bowel obstruction resulted in a CT scan, administration of a soap suds enema, and adjustments to the resident’s laxative regimen. These events occurred in the context of the facility not initiating the bowel protocol as required by its own policy and the resident’s orders.
Improper Hoyer Lift Use Leads to Resident Fall and Pelvic Fracture
Penalty
Summary
The deficiency involves the facility’s failure to ensure safe use of a mechanical (Hoyer) lift during a resident transfer, resulting in a fall and injury. The resident involved had diagnoses including bipolar disorder, post-traumatic stress disorder, and hemiplegia with hemiparesis following a cerebrovascular event affecting the left non-dominant side, and was dependent on staff for all ADLs. Physician orders required use of a mechanical lift for all transfers, and repeated fall risk assessments consistently identified the resident as being at high risk for falls. On the day of the incident, at approximately 10:30 A.M., a charge nurse heard a loud noise and entered the resident’s room, finding the resident lying on the floor next to the bed with two CNAs present and a wheelchair and Hoyer lift nearby. Immediate assessment revealed no visible injuries, but the resident reported slipping from the Hoyer lift sling and complained of pain to the left elbow and left side of the face. The resident was kept on the floor for safety until further evaluation, and EMS, the facility NP, and the resident’s family were notified. Subsequent hospital evaluation documented that the resident reported pain to the left side of the head, left elbow, and left hip, and pelvis radiographs showed acute fractures of the left superior and inferior pubic rami. The facility’s investigation determined that during the transfer from bed to wheelchair, one of the Hoyer lift pad straps had not been secured to the spreader bar, causing the resident to slip from the sling and fall. Written statements from both CNAs confirmed the failure to secure the strap, and the DON confirmed that the injury was caused by improper securing of the Hoyer lift sling. The resident later expressed apprehension about being transferred with the Hoyer lift following the incident.
Food Served at Unappetizing Temperature
Penalty
Summary
The facility failed to ensure food was served at an appetizing temperature. During observation of lunch meal temperatures before service, two trays of breaded chicken patties were measured at 165.2 degrees Fahrenheit and 167.0 degrees Fahrenheit, and the rice was measured at 200.0 degrees Fahrenheit. During lunch tray line service, the facility completed tray line pass, but the cook ran out of plates and began using divided dishes for the last three trays served, and a test tray was served on the final cart. When the test tray was observed after resident tray pass, the breaded chicken patty on a bun measured 102.8 degrees Fahrenheit and the rice measured 110.2 degrees Fahrenheit, and a taste test found both items were lukewarm. Mobile Dietary Manager #299 confirmed the food was not palatable and stated she would microwave the meal. The facility policy stated hot foods would be held at 135.0 degrees Fahrenheit or greater throughout the service process.
Kitchen Sanitation and Dish Machine Temperature Deficiencies
Penalty
Summary
The facility failed to maintain a clean and sanitary kitchen area during observations of the kitchen, dry storage room, dish machine area, and food prep surfaces. The kitchen had a leaking sink plumbing line draining into a plastic container on the floor, debris under storage racks, sticky floors with crumbs and debris throughout the kitchen, spilled thickener powder on a prep table, food debris on prep table shelves, dried food splatter on kitchen equipment and a sink under the hood, a dripping faucet, scale buildup on the outside of the dish machine, multiple dead bugs in ceiling light fixtures, steel wool on the floor under the dish machine, and leftover food debris on the dirty side of the dish machine. The plastic carts holding dishes also had dried food splatter and debris, and one cart contained leftover food including carrots, biscuits, and fried chicken from the previous night. The dish machine cycle did not reach the required sanitation temperatures, with the wash cycle at 150 degrees F and the rinse cycle at 176 degrees F, while the facility policy required a final rinse temperature of 180.0 degrees F to 194.0 F. A plastic bin with sugar and artificial sweetener packets was stored on a table with chemicals, including floor cleaner. The Dietary Manager confirmed the findings and stated he had only been employed for about a month and a half, that there were no written cleaning schedules, and that he would make a list for staff when things needed done. The facility policy required kitchen sanitation through a written, comprehensive cleaning schedule and required food storage areas to be clean, dry, free of contamination, and chemicals stored away from food.
Pest Control Program Failed to Address Flies in Kitchen Areas
Penalty
Summary
The facility failed to effectively manage pests in the kitchen area. During observation of the kitchen and dish machine areas, multiple flies were seen throughout the kitchen area and dish machine areas, and the Dietary Manager confirmed their presence. Review of the pest control company invoice showed the kitchen, dishwashing area, and dry goods storage area received a general pest treatment, but it did not include house flies or fruit flies. Facility policy stated pests would be controlled in and around all buildings to reduce potential human health hazards and identified flies as common pests, and the food storage policy stated storage areas would be free from rodent and insect infestation.
Call Light Not Kept Within Resident Reach
Penalty
Summary
The facility failed to ensure a call light was within reach for Resident #91. Resident #91 was admitted on 04/13/21 and readmitted on 05/22/23, with diagnoses including diabetes mellitus type two, unspecified dementia, generalized anxiety, major depressive disorder, cirrhosis of the liver, chronic hepatitis C, clostridium difficile, and chronic obstructive pulmonary disease. A quarterly MDS assessment showed a BIMS score of 13, indicating the resident was cognitively intact, and also documented that the resident required substantial to maximum assistance with toileting and showers, partial to moderate assistance with dressing, and was occasionally incontinent of bowel and bladder. The care plan dated 06/19/25 included interventions to encourage placing the call light in reach or off the floor and to clip it to the sheets or bed. However, on 07/21/25 at 9:39 A.M. and again on 07/22/25 at 4:09 P.M., observations showed Resident #91 lying in bed with the call light on the floor on the right side of the bed. Housekeeping Supervisor #298 and CNA #212 each verified that the call light was on the floor during the observations. The facility policy titled Resident Call System stated that when leaving the room, staff should be sure the call light is placed within the resident's reach.
Failure to Provide Oral Care and Shaving per Preference
Penalty
Summary
The facility failed to ensure that Resident #6 received oral care and was shaved according to his preference. Resident #6 was admitted with diagnoses including Huntington's disease, major depressive disorder, muscle weakness, and unspecified lack of coordination. His care plan dated 03/27/25 identified a goal that he would be clean, dry, dressed, groomed, and free of odors, and also noted a preference to be clean shaven. The MDS quarterly assessment showed he was rarely or never understood, had short-term and long-term memory impairment, and was dependent on staff for all ADLs. During interview, a family member stated the resident was often unshaven and his teeth were not brushed, and reported that before becoming dependent on staff he had been meticulous about his hygiene and always clean shaven. Observation showed the resident in bed wearing a hospital gown with a full, short beard and moustache, and later his teeth were covered with a thick film and his lips had visible dry crust. An LPN confirmed oral care was needed and stated it was expected every shift. A CNA stated nursing staff did not shave the resident and that he went to the beauty shop to be shaved. The beautician stated she only trimmed the resident's beard and did not shave him, explaining it was not safe because he did not sit still enough, and said nursing was to shave him after she trimmed his beard. The DON stated residents were expected to be shaved per preference and that staff including CNAs and activity staff could shave residents with an electric razor, but she believed the resident had been shaved by the beautician and was not aware he had not been shaved.
Missing Smoking Assessment for Resident Found Smoking on Facility Grounds
Penalty
Summary
The facility failed to ensure a smoking assessment was completed for a resident who was smoking on the facility premises. Resident #54 was admitted on 07/14/25 with diagnoses including hemarthrosis of the right knee, type 2 diabetes mellitus with chronic kidney disease, end stage renal disease, and dependence on renal dialysis. The medical record did not contain documented evidence of a smoking assessment to determine the resident’s capabilities and deficits or whether supervision was required. The admission MDS 3.0 indicated intact cognition, wheelchair use, and the need for supervision with mobility and moderate assistance with dressing, toileting, and bathing. The care plan dated 07/14/25 did not include a smoking-related care plan. A nursing progress note dated 07/15/25 documented that the Social Services Designee spoke with the resident about the facility being non-smoking and provided education on the smoking policy, including that he must sign out each time he went out to smoke and must go off the facility property to smoke. On 07/21/25, the resident was observed smoking outside on a bench across from the facility entrance, with no ash tray present and a no smoking sign near the entrance. The Administrator confirmed the facility was non-smoking and that the resident was not supposed to be smoking on the grounds. The LPN confirmed the resident was aware before admission that the facility was not a smoking facility and stated a smoking plan should have been in place after the smoking incident. The DON and Administrator confirmed the resident was caught smoking outside on 07/15/25 and that a smoking assessment was not completed after the incident.
Infection Control Not Followed During Incontinence Care
Penalty
Summary
Infection prevention and control guidelines were not followed during incontinence care for one resident who was dependent on staff for all activities of daily living and was always incontinent of bowel and bladder. The resident had diagnoses including Huntington's disease, major depressive disorder, muscle weakness, and unspecified lack of coordination. The resident's care plan required enhanced barrier precautions related to the use of a feeding tube, including hand hygiene before and after glove use, use of disposable gowns and gloves during high-contact care activities, and prompt removal and disposal of gowns and gloves after care activities. A physician order also directed enhanced barrier precautions while providing care. During an observation of incontinence care, one CNA cleansed the resident's buttocks and groin area and did not remove her gloves afterward. The CNA then touched clean bed linens, the privacy curtain, and the resident's overbed table with the contaminated gloves. A second CNA removed soiled linen and an adult brief from under the resident and placed them on the floor. In interview, both CNAs confirmed that the gloves should have been removed after incontinence care and that the soiled linens should have been placed in a bag once removed from the bed.
Deficient Medication Administration and Documentation Practices
Penalty
Summary
The facility failed to ensure accurate documentation and proper handling of medication administration, particularly with controlled substances, affecting seven residents. In several instances, documentation on controlled substance accountability sheets was inaccurate, including incorrect recording of dates, times, amounts administered, and quantities remaining. For example, one resident's records showed inconsistencies in the number of tablets dispensed and remaining, and it was unclear whether medications were removed from the medication cart or the electronic dispensing system. Registered nurses involved confirmed the documentation errors during interviews. There were also failures in following physician orders and proper medication administration protocols. One nurse removed multiple residents' as-needed controlled medications from the electronic dispensing system at the same time, intending to administer them later during her shift, rather than as needed. Another resident received oxycodone earlier than prescribed, with insufficient documentation to confirm the timing and administration of the dose. Additionally, a nurse administered liquid morphine to a resident without a physician order, and the source of the medication was unclear. In another case, documentation indicated a resident received Ativan, but the medication was actually administered to a different resident, resulting in inaccurate clinical records. The facility's medication administration policy required strict adherence to the five rights of medication administration and proper documentation immediately after administration. However, the findings revealed multiple deviations from these protocols, including administering medications without orders, removing as-needed medications in advance of need, and failing to document administration accurately. These actions and inactions led to the cited deficiencies in pharmaceutical services and medication management.
Failure to Perform Hand Hygiene and Initiate Isolation Precautions
Penalty
Summary
Staff failed to perform proper hand hygiene during medication administration for two residents. An LPN administered multiple oral medications to one resident, including opening capsules with bare hands and mixing them with applesauce, without performing hand hygiene before or after the process. The same LPN then administered medications to a second resident, again failing to perform hand hygiene after the medication pass. These actions were observed and later confirmed in an interview with the LPN, and were not in accordance with the facility's policy, which requires handwashing before and after medication administration and after direct resident contact. Additionally, the facility failed to implement isolation precautions for a resident who was readmitted with a diagnosis of influenza A. The resident exhibited symptoms such as a moist cough and abnormal lung sounds and was receiving antiviral medication. Despite these symptoms and a confirmed diagnosis, there was no documentation in the medical record or physician orders indicating that isolation precautions were initiated for this resident. The facility's policies on medication administration and transmission-based precautions were reviewed and found to require hand hygiene and the initiation of isolation precautions for residents with transmissible infections. The Director of Nursing confirmed that isolation precautions were not implemented for the resident with influenza A, and the observed medication administration practices did not follow the facility's established guidelines.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Parma
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Broadview Multi Care Center | 0.1 mi | ★★★★★ | 6 | 0 |
| Seven Hills Health & Rehab Center | 0.8 mi | ★★★★★ | 0 | 0 |
| Mt Alverna Home Inc | 2.3 mi | ★★★★★ | 7 | 0 |
| Snf-the Villa At Marymount | 2.5 mi | ★★★★★ | 0 | 0 |
| Avenue At Brooklyn | 2.6 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.